User interface for neuromodulation lead

ABSTRACT

Systems and methods for determining a parameter set and programming a neuromodulation system with the parameter set are disclosed. The system includes a user interface having a display screen to display simplified graphical representations (SGRs) of the lead with at least one virtual electrode (VE) that represents one or more electrodes, and control elements. The SGRs of the lead can provide longitudinal and circumferential representations of the VE, respectively representing longitudinal or circumferential position, size, shape, or spread of the VE. The control elements may include longitudinal and circumferential control elements to enable the user to respectively adjust the longitudinal or circumferential position, size, shape, or spread of the VE. The system may generate the neuromodulation parameter set using the longitudinal and circumferential representations of the VE, and program the neuromodulation system with the neuromodulation parameter set.

CLAIM OF PRIORITY

This application claims the benefit of priority under 35 U.S.C. § 119(e)of U.S. Provisional Patent Application Ser. No. 62/218,959, filed onSep. 15, 2015, which is herein incorporated by reference in itsentirety.

TECHNICAL FIELD

This document relates generally to medical devices, and moreparticularly, to systems, devices, and methods for deliveringneuromodulation to a neutral target.

BACKGROUND

Neuromodulation, also referred to as neuromodulation, has been proposedas a therapy for a number of conditions. Examples of neuromodulationinclude Spinal Cord Stimulation (SCS), Deep Brain Stimulation (DBS),Peripheral Nerve Stimulation (PNS), and Functional ElectricalStimulation (FES). Implantable neuromodulation systems have been appliedto deliver such a therapy. An implantable neuromodulation system mayinclude an implantable neuromodulator, also referred to as animplantable pulse generator, and one or more implantable leads eachincluding one or more electrodes. The implantable neuromodulator maydeliver neuromodulation energy through one or more electrodes placed onor near a target neural tissue. An external programming device may beused to program the implantable neuromodulator with parameterscontrolling the delivery of the neuromodulation energy.

OVERVIEW

Efficacy and efficiency of certain neuromodulation therapies may beaffected by the electrode selection and fractionalized electrodeconfiguration. Proper configuration of neuromodulation electrodes mayallow the lead to be used to more accurately target a tissue that isdesired to be modulated while avoiding or reducing undesirableside-effects caused by unintentionally modulating neighboring cellpopulations next to or around the target neural structures.Additionally, proper electrode selection and fractionalized electrodeconfiguration may also reduce energy consumption and thereby extendinglongevity of the implantable neuromodulator.

Some neuromodulation systems, such as those used for DBS or SCS, mayinclude leads that have a large number of electrodes available forstimulating neural targets. A lead may have a complex arrangement ofmultiple electrodes that not only are distributed axially along theleads, but are also distributed circumferentially around the lead. Sucha lead, also known as a directional lead, presents a multitude ofselections of modulation parameter sets to the clinician.

Current programming systems for determining modulation parameterstypically include depictions of multiple electrodes on a display screenwith actual geometric or physical properties of the electrodes, such assize, shape, dimension, position, orientation, inter-electrode spacing,among others. Information about electrode configurations and themodulation parameters are also displayed, such as electrode polarity,electrode combinations that define neuromodulation vectors, orfractionalized current distribution, among others. With increased numberand complexity of electrodes in a lead (such as a directional lead), theamount of information presented to a system user, such as a clinician,may be overwhelming. As a result, programming of the neuromodulationsystem may become more complicated and time consuming. Embodiments ofthe present subject matter provide a programming system that may enablea system user to effectively and efficiently determine a neuromodulationparameter set, including select and configure electrodes for deliveringneuromodulation to a neural target.

This document discusses, among other things, an embodiment of a systemfor use with a neuromodulation system that includes a lead having one ormore electrodes at least partially surrounding a circumference of thelead for electrically modulating a target tissue of a patient. Thesystem includes a user interface having a display screen to displaysimplified graphical representations (SGRs) of the lead with at leastone virtual electrode (VE) that represents one or more electrodes, andcontrol elements. The SGRs of the lead provide longitudinal andcircumferential representations of the VE, respectively representinglongitudinal or circumferential position, size, shape, or spread of theVE. The control elements may include longitudinal and circumferentialcontrol elements to enable the user to respectively adjust thelongitudinal or circumferential position, size, shape, or spread of theVE. The system may generate the neuromodulation parameter set using thelongitudinal and circumferential representations of the VE, and programthe neuromodulation system with the neuromodulation parameter set.

In Example 1, a system for use with a neuromodulation system thatincludes a lead having one or more electrodes at least partiallysurrounding a circumference of the lead for electrically modulating atarget tissue of a patient is disclosed. The system can comprise a userinterface and a programmer module. The user interface can includes adisplay screen that can display simplified graphical representations(SGRs) of the lead with at least one virtual electrode (VE), and controlelements that enable a user to adjust the SGRs of the lead. The SGRs caninclude one or more of at least a first view of the lead to provide alongitudinal representation of the VE representing a longitudinalposition of the VE along a length of the lead, or at least a second viewof the lead to provide a circumferential representation of the VErepresenting a circumferential position of the VE around at least aportion of a circumference of the lead. The control elements can includelongitudinal control elements that enable the user to adjust thelongitudinal representation of the VE including the longitudinalposition of the VE along the length of the lead, and circumferentialcontrol elements that enable the user to adjust the circumferentialrepresentation of the VE including the circumferential position of theVE. The programmer module can be coupled to the user interface, and canuse the longitudinal representation of the VE and the circumferentialrepresentation of the VE to generate a neuromodulation parameter set.

Example 2 can include, or can optionally be combined with the subjectmatter of Example 1 to optionally include, the display screen that candisplay the SGRs including the first view illustrating a longitudinallength of a portion of the lead, and the second view is a sectional viewof the lead.

Example 3 can include, or can optionally be combined with the subjectmatter of one or any combination of Examples 1 or 2 to include, thedisplay screen that can display the control elements that can includeone or more view control elements to enable a user to select between atleast the first and second views of the lead.

Example 4 can include, or can optionally be combined with the subjectmatter of one or any combination of Examples 1 through 3 to include, thedisplay screen that can display the SGRs of the lead including two ormore VEs. The control elements can include at least one VE activationcontrol element to selectively activate, deactivate, show, or hide atleast one of the two or more VEs.

Example 5 can include, or can optionally be combined with the subjectmatter of one or any combination of Examples 1 through 4 to include, thedisplay screen that can display the first view of the lead including arepresentation of longitudinal size, shape, or spread of the VE alongthe length of the lead, and display the longitudinal control elementsthat enable the user to adjust the longitudinal size, shape, or spreadof the VE.

Example 6 can include, or can optionally be combined with the subjectmatter of Example 5 to optionally include, the display screen that candisplay the longitudinal control elements including at least onelongitudinal position icon with a longitudinal direction indicator, andat least one longitudinal spread icon with a longitudinal spreadindicator. The longitudinal position icon can enable a user toincrementally adjust the longitudinal representation of the VE along thelead representation in a direction according to the at least onelongitudinal direction indicator. The longitudinal spread icon canenable a user to incrementally adjust a longitudinal size, shape, orspread of the longitudinal representation of the VE in the first view.

Example 7 can include, or can optionally be combined with the subjectmatter of Example 5 to optionally include, the display screen that candisplay the longitudinal control elements that enable a user to adjustthe longitudinal position using a selection and control method to selecta first portion of the longitudinal representation of the VE and editthe longitudinal representation of the VE along the lead, and to adjustthe longitudinal size, shape, or spread using the selection and controlmethod to select a second portion of the longitudinal representation ofthe VE and edit an edge of the longitudinal representation of the VEalong the lead to adjust a longitudinal dimension of the longitudinalrepresentation of the VE in the first view.

Example 8 can include, or can optionally be combined with the subjectmatter of one or any combination of Examples 1 through 7 to include, thedisplay screen that can display the longitudinal control elements thatenable a user to adjust, in the first view, one or more of a polarity ofthe longitudinal representation of the VE, a neuromodulation vectorconfiguration, or a distance between the longitudinal representation ofthe VE and a longitudinal representation of a reference electrode.

Example 9 can include, or can optionally be combined with the subjectmatter of one or any combination of Examples 1 through 8 to include, thedisplay screen that can display the second view of the lead including arepresentation of circumferential size, shape, or spread of the VEaround a circumference of the lead, and the circumferential controlelements that enable the user to adjust the circumferential size, shape,or spread of the VE.

Example 10 can include, or can optionally be combined with the subjectmatter of Example 9 to optionally include, the display screen that candisplay the circumferential control elements including at least onecircumferential position icon with a circumferential directionindicator, and at least one circumferential spread icon with acircumferential spread indicator. The circumferential position iconenables a user to incrementally rotate the circumferentialrepresentation of the VE around the circumference of the lead in adirection according to the circumferential direction indicator. Thecircumferential spread icon enables a user to incrementally adjust acircumferential size, shape, or spread of the circumferentialrepresentation of the VE in the second view.

Example 11 can include, or can optionally be combined with the subjectmatter of Example 9 to optionally include, the display screen that candisplay the circumferential control elements that enable a user toadjust the circumferential position using a selection and control methodto select a first portion of the circumferential representation of theVE and edit the circumferential representation of the VE around thecircumference of the lead. The circumferential control elements canenable a user to adjust the circumferential size, shape, or spread usingthe selection and control method to select a second portion of thecircumferential representation of the VE and edit an edge of thecircumferential representation of the VE around the circumference of thelead to adjust the circumferential dimension of the circumferentialrepresentation of the VE in the second view.

Example 12 can include, or can optionally be combined with the subjectmatter of one or any combination of Examples 1 through 11 to include,the display screen that can display the circumferential representationof the VE including a ring or an arc around the lead, and display thecircumferential spread of the VE including an angle of the ring or thearc.

Example 13 can include, or can optionally be combined with the subjectmatter of one or any combination of Examples 1 through 12 to include,the programmer module that can determine the neuromodulation parameterset, including develop an electrode configuration and a fractionalizedcurrent distribution among at least some of the plurality of electrodesusing the longitudinal representation of the VE and the circumferentialrepresentation of the VE.

Example 14 can include, or can optionally be combined with the subjectmatter of one or any combination of Examples 1 or 13 to include, aneuromodulation system that can include an electrostimulation generatorand a programming system including the programmer module and the userinterface. The electrostimulation generator can be operably connected tothe neuromodulation lead to deliver neuromodulation using the lead. Theprogramming system can be communicatively coupled to the neuromodulationsystem, and can program the neuromodulation system with theneuromodulation parameter set.

Example 15 can include, or can optionally be combined with the subjectmatter of Example 14 to optionally include, the neuromodulation systemthat can modulate a target neural tissue including a brain or a spinalcord using the lead.

In Example 16, a system can include a neuromodulation system and aprogramming system communicatively coupled to the neuromodulationsystem. The neuromodulation system can include an electrostimulationgenerator that can be operably connected to a lead having a plurality ofelectrodes along a longitudinal direction of the lead. At least some ofthe electrodes can be at least partially surrounding a circumference ofthe lead. The programming system can include a display screen that canbe configured to display simplified graphical representations (SGRs) ofthe lead with at least one virtual electrode (VE), and control elementsto enable a user to adjust the SGRs of the lead. The SGRs can includeone or more of at least a first view of the lead or at least a secondview of the lead. The first view can provide a longitudinalrepresentation of the VE representing a longitudinal position of the VEalong a length of the lead, and a longitudinal size, shape, or spread ofthe VE along the length of the lead. The second view can provide acircumferential representation of the VE representing a circumferentialposition of the VE around at least a portion of a circumference of thelead, and a circumferential size, shape, or spread of the VE around thecircumference of the lead. The control elements can include longitudinalcontrol elements and circumferential control elements. The longitudinalcontrol elements enable the user to adjust the longitudinalrepresentation of the VE including the longitudinal position and thelongitudinal size, shape, or spread of the VE, and the circumferentialcontrol elements enable the user to adjust the circumferentialrepresentation of the VE including the circumferential position and thecircumferential size, shape, or spread of the VE. The programming systemcan use the longitudinal representation of the VE and thecircumferential representation of the VE to determine a neuromodulationparameter set, and program the neuromodulation system using theneuromodulation parameter set.

In Example 17, a method can be used for generating a neuromodulationparameter set to program a neuromodulation system that includes a leadhaving one or more electrodes at least partially surrounding acircumference of the lead for electrically modulating a target tissue ofa patient. The method can include steps of providing a user interfacethat includes a display screen, and display on the display screensimplified graphical representations (SGRs) of the lead with at leastone virtual electrode (VE), and control elements that enable a user toadjust the SGRs of the lead. The SGRs can include one or more of atleast a first view of the lead that can provide a longitudinalrepresentation of the VE representing a longitudinal position of the VEalong a length of the lead, and a longitudinal size, shape, or spread ofthe VE along the length of the lead, or at least a second view of thelead that can provide a circumferential representation of the VErepresenting a circumferential position of the VE around at least aportion of a circumference of the lead, and a circumferential size,shape, or spread of the VE around the circumference of the lead. Thecontrol elements can include longitudinal control elements andcircumferential control elements. The longitudinal control elementsenable the user to adjust the longitudinal representation of the VEincluding the longitudinal position and the longitudinal size, shape, orspread of the VE. The circumferential control elements enable the userto adjust the circumferential representation of the VE including thecircumferential position and the circumferential size, shape, or spreadof the VE. The method can include steps of determining, for the at leastone VE, one or more of a desired longitudinal position, a desiredlongitudinal size, shape, or spread, a desired circumferential position,a desired circumferential size, shape, or spread, and generating aneuromodulation parameter set using the longitudinal representation ofthe VE and the circumferential representation of the VE for deliveringneuromodulation using the lead.

Example 18 can include, or can optionally be combined with the subjectmatter of Example 17 to optionally include, displaying the first view ofthe lead including a view illustrating a longitudinal length of aportion of the lead, and the second view including a sectional view ofthe lead, and displaying the control elements including one or more viewcontrol elements that enable a user to select between at least the firstand second views of the lead.

Example 19 can include, or can optionally be combined with the subjectmatter of Example 17 to optionally include, displaying the longitudinalcontrol elements including displaying at least one longitudinal positionicon with a longitudinal direction indicator and at least onelongitudinal spread icon with a longitudinal spread indicator. Thelongitudinal position icon enables a user to incrementally adjust thelongitudinal representation of the VE along the lead representation in adirection according to the at least one longitudinal directionindicator. The longitudinal spread icon enables a user to incrementallyadjust a longitudinal size, shape, or spread of the longitudinalrepresentation of the VE in the first view.

Example 20 can include, or can optionally be combined with the subjectmatter of Example 17 to optionally include, displaying the longitudinalcontrol elements that enable a user to adjust the longitudinal positionusing a selection and control method to select a first portion of thelongitudinal representation of the VE and edit the longitudinalrepresentation of the VE along the lead, and to adjust the longitudinalsize, shape, or spread using the selection and control method to selecta second portion of the longitudinal representation of the VE and editan edge of the longitudinal representation of the VE along the lead toadjust a longitudinal dimension of the longitudinal representation ofthe VE in the first view.

Example 21 can include, or can optionally be combined with the subjectmatter of Example 17 to optionally include, displaying thecircumferential control elements that include at least onecircumferential position icon with a circumferential directionindicator, and at least one circumferential spread icon with acircumferential spread indicator. The circumferential position iconenables a user to incrementally rotate the circumferentialrepresentation of the VE around the circumference of the lead in adirection according to the circumferential direction indicator. Thecircumferential spread icon enables a user to incrementally adjust acircumferential size, shape, or spread of the circumferentialrepresentation of the VE in the second view.

Example 22 can include, or can optionally be combined with the subjectmatter of Example 17 to optionally include, displaying thecircumferential control elements that enable a user to adjust thecircumferential position using a selection and control method to selecta first portion of the circumferential representation of the VE and editthe circumferential representation of the VE around the circumference ofthe lead, and to adjust the circumferential size, shape, or spread usingthe selection and control method to select a second portion of thecircumferential representation of the VE and edit an edge of thecircumferential representation of the VE around the circumference of thelead to adjust the circumferential dimension of the circumferentialrepresentation of the VE in the second view.

Example 23 can include, or can optionally be combined with the subjectmatter of Example 17 to optionally include, steps of programming theneuromodulation system with the neuromodulation parameter set, anddelivering neuromodulation using neuromodulation system according to theneuromodulation parameter set.

This Overview is an overview of some of the teachings of the presentapplication and not intended to be an exclusive or exhaustive treatmentof the present subject matter. Further details about the present subjectmatter are found in the detailed description and appended claims. Otheraspects of the invention will be apparent to persons skilled in the artupon reading and understanding the following detailed description andviewing the drawings that form a part thereof, each of which are not tobe taken in a limiting sense. The scope of the present invention isdefined by the appended claims and their legal equivalents.

BRIEF DESCRIPTION OF THE DRAWINGS

Various embodiments are illustrated by way of example in the figures ofthe accompanying drawings. Such embodiments are demonstrative and notintended to be exhaustive or exclusive embodiments of the presentsubject matter.

FIG. 1 illustrates, by way of example and not limitation, an example ofan implantable neuromodulation system (INS) and portions of theenvironment in which the INS operates.

FIGS. 2A-B illustrate, by way of example and not limitation, profileviews of a neuromodulation system.

FIG. 3 illustrates, by way of example and not limitation, a portion of aneuromodulation system for modulating a target neural tissue.

FIG. 4 illustrates, by way of example and not limitation, simplifiedgraphical representations (SGRs) of one or more leads and thecorresponding control elements.

FIGS. 5A-B illustrate, by way of example and not limitation, SGRs of alead with two virtual electrodes (VEs) displayed on a display screen.

FIGS. 6A-B illustrate, by way of example and not limitation, SGRs of alead with a VE in different views on a display screen.

FIGS. 7A-C illustrate, by way of example and not limitation, VEs withdifferent circumferential shapes and spreads on a cross-sectional viewof a lead as displayed on a display screen.

FIG. 8 illustrates, by way of example and not limitation, a plan view ofat least a portion of a user interface.

FIG. 9 illustrates, by way of example and not limitation, a method forcreating and using SGRs of a lead to determine a neuromodulationparameter set.

DETAILED DESCRIPTION

Disclosed herein are systems and methods for determining a parameter setand programming a neuromodulation system with the parameter set. Theneuromodulation system includes a lead having one or more electrodes atleast partially surrounding a circumference of the lead for electricallymodulating a target tissue of a patient. The disclosed system includes auser interface that may display simplified graphical representations(SGRs) of the lead with at least one virtual electrode (VE) thatrepresents one or more electrodes, and control elements. The SGRs of thelead provide longitudinal and circumferential representations of the VE,respectively representing longitudinal or circumferential position,size, shape, or spread of the VE. A user may adjust the longitudinal orcircumferential position, size, shape, or spread of the VE using thecontrol elements. The simplified representation of the lead and the VEenables the user to more efficiently determine a neuromodulationparameter set to be programmed to the neuromodulation system.

FIG. 1 illustrates, by way of example and not limitation, an example ofan implantable neuromodulation system (INS) 100 and portions of theenvironment in which the INS 100 operates. In some embodiments the INS100 may be used for deep brain stimulation (DBS) within a brain 102 of apatient 101. The INS may include an implantable pulse generator (IPG)110, a lead system that includes leads 130 and lead extension 120 fordelivering modulation pulses to target tissue, a programming system 180,and optionally an intermediate controller 160. The INS may be used toprovide SCS or modulate other neural or muscular targets. For example,an SCS lead may be used to target a specific region of spinal cordtissue (which may include, by way of example and not limitation, dorsalcolumn, dorsal horn, spinal nerve roots such as the dorsal nerve root,and dorsal root ganglia).

The IPG 110 may comprise a hermetically sealed outer case, also known asa “can”, for housing a battery and pulse generation circuitry thatdelivers the electrical stimulation energy via one or more percutaneouslead extensions 120 to one or more leads such as a lead 130, which maycarry a plurality of electrodes 140 distributed along the lead 130. Theelectrical stimulation energy may take in the form of a pulsedelectrical waveform to the electrodes 140 in accordance with a set ofmodulation parameters programmed into the IPG 110. Electricalstimulation will occur between two or more activated electrodes, one ofwhich may be the IPG case. Neuromodulation energy may be transmitted tothe tissue in a unipolar or multipolar (e.g., bipolar, tripolar, etc.)configuration. Monopolar stimulation occurs when a selected one of theelectrodes 140 is activated along with the case of the IPG 110, so thatstimulation energy is transmitted between the selected electrode and thecase. Bipolar stimulation occurs when two of the lead electrodes 140 areactivated as anode and cathode, so that stimulation energy istransmitted between the selected electrodes 140. Tripolar stimulationoccurs when three of the lead electrodes 140 are activated, two asanodes and the remaining one as a cathode, or two as cathodes and theremaining one as an anode.

The leads 130 may be introduced through a burr hole 103 (oralternatively, two respective burr holes) formed in the cranium 104 ofthe patient 101, and introduced into the parenchyma of the brain 102 ofthe patient 101 in a conventional manner, such that the electrodes 140are adjacent a target tissue region, the stimulation of which will treatthe dysfunction (e.g., the ventrolateral thalamus, internal segment ofglobus pallidus, substantia nigra pars reticulate, subthalamic nucleus,or external segment of globus pallidus). Stimulation energy may beconveyed from the electrodes 140 to the target tissue to change thestatus of the dysfunction. The IPG 110 may be implanted in asurgically-made pocket either in the chest, the abdomen, or otherlocations of the patient's body. The lead extension 130 facilitateslocating the IPG 110 away from the exit point of the leads 130.

The programming system 180 may be communicatively coupled to the IPG110, such as via a radio-frequency (RF) communications link (not shown).The programming system 180 may present to a system user, such as aclinician, neuromodulation parameters for programming the IPG 110, andenable the system user to program the IPG 110 using the neuromodulationparameters. Such neuromodulation parameters may include electrodecombinations, which define the electrodes that are activated as anodes(positive), cathodes (negative), and turned off (zero), percentage ofstimulation energy assigned to each electrode (fractionalized electrodeconfigurations), and electrical pulse parameters, which define the pulseamplitude (which may be measured in milliamps or volts depending onwhether the IPG 110 supplies constant current or constant voltage to theelectrodes 140), pulse duration (which may be measured in microseconds),pulse rate (measured in pulses per second), and burst rate (which may bemeasured as the stimulation on duration X and stimulation off durationY). The programming of the IPG 110 may be performed intraoperatively(e.g., during implant of the IPG 110 and/or the leads 130 in anoperating room) or during a follow-up visit with the patient.

The programming system 180 may alternatively indirectly communicate withthe IPG 10 through an intermediate controller, such as an externalremote controller (RC) 160 that may telemetrically control the IPG 110via a bi-directional communications link 150, such as a radio-frequencycommunication link. The programming system 180 may communicate with theRC 160 such as via an infrared communications link 170. Theneuromodulation parameters provided by the programming system 180 mayalso be used to program the RC 160, so that the neuromodulationparameters may be subsequently modified by operation of the RC 160 inwithout the assistance of the programming system 180. In an example, theprogramming system 180, either alone or in combination with the RC 160,may control the operation of the IPG 110, such as turning on or off andprogramming the IPG 110 with different neuromodulation parameter sets toactively control the characteristics of the electrical modulation energyoutput by the IPG 110.

FIGS. 2A-B illustrate, by way of example and not limitation, profileviews of neuromodulation system. FIG. 2A illustrates an implantablepulse generator (IPG) 210, which may be an embodiment of the IPG 110 asshown in FIG. 1, and two leads 230A and 230B configured to be operablyconnected to the IPG 210. Each of the lead may have a plurality ofelectrodes 240 that may be used for neuromodulation of a brain tissue.The illustrated leads 230A and 230B each includes an elongatedcylindrical lead body, and the electrodes 240 take the form of segmentedelectrodes that are circumferentially and axially disposed about thelead body. In a non-limiting example, and as illustrated in FIG. 2A, theneurostimulation lead 230A or 230B may carry sixteen electrodes,arranged as four rings of electrodes, or four axial columns ofelectrodes. The actual number and shape of leads and electrodes may varyaccording to the intended application. Detailed description ofconstruction and method of manufacturing percutaneous stimulation leadsare disclosed in U.S. Pat. No. 8,019,439, entitled “Lead Assembly andMethod of Making Same,” and U.S. Pat. No. 7,650,184, entitled“Cylindrical Multi-Contact Electrode Lead for Neural Stimulation andMethod of Making Same,” the disclosures of which are incorporated hereinby reference.

FIG. 2B illustrates an implantable pulse generator (IPG) 215, which maybe an embodiment of the IPG 110 as shown in FIG. 1, and two leads 235Aand 235B configured to be operably connected to the IPG 215. Each of thelead may have a plurality of electrodes 245 that may be used forneuromodulation of a region of a spinal cord. The leads 235A and 235Beach includes an elongated cylindrical lead body and the electrodes 245take the form of column electrodes (also known as ring electrodes)axially disposed along the length of the lead body. In a non-limitingexample, and as illustrated in FIG. 2B, the leads 235A or 235B may carryeight electrodes along the lead body with specified electrode size,shape, and inter-electrode spacing.

FIG. 3 illustrates, by way of example and not limitation, an example ofa portion of a neuromodulation system 300 for modulating a target neuraltissue. The neuromodulation system 300 may be used for deep brainstimulation (DBS), spinal cord stimulation (SCS), a peripheral nervestimulation (PNS), or stimulation of other neural targets or musculartargets. The neuromodulation system 300 may include a neuromodulationsystem 310 and a neuromodulation programming system 380.

The neuromodulation system 310 may include pulse generation circuitrythat generate electrical stimulation energy, such as pulsed electricalwaveform, and deliver the electrical stimulation energy to a neuraltarget. Examples of the neuromodulation system 310 may include one ofthe IPGs 110, 210, or 215 as shown in FIGS. 1-2. The neuromodulationsystem 310 may be connected to one or more leads each carrying one ormore electrodes, and deliver stimulation energy to the one or moreelectrodes in accordance with a set of modulation parameters programmedinto the neuromodulation system 310.

The neuromodulation programming system 380 may be a dedicatedhardware/software system, such as a programmer or a remote server-basedpatient management such as the programming system 180 as shown inFIG. 1. The neuromodulation programming system 380 may alternatively bedefined predominantly by software running on a standard personalcomputer (PC). The neuromodulation programming system 380 maycommunicate with the neuromodulation system 310 via a communication link370, such as an inductive telemetry link or a radio-frequency telemetrylink. The neuromodulation programming system 380 may include one or moreof a user interface 381, a programmer module 384, a controller circuit385, a memory circuit 386, and an input/output (I/O) circuit 387.

The user interface 381 may include a display screen that may beconfigured, such as by the controller circuit 385, to display asimplified graphical representation (SGR) 382 of one or more leads,along with representation of one or more virtual electrodes (VEs)associated with the lead representation. The SGR of the lead is a“simplified” representation of an actual lead (such as leads 230A-b or235A-B in FIGS. 2A and 2B), rather than a proportional depiction of thecorresponding lead with actual physical size, shape, extent, ordimension. Likewise, a VE is a “simplified” representation of oneelectrode or an array of electrodes (such as electrodes 240 or 245 inFIGS. 2A and 2B), rather than a scaled depiction of an electrode withgeometric or physical properties such as actual size, shape, spread,dimension, position or orientation with respect to the lead body, orinter-electrode spacing, among others. In an example, the SGR mayinclude a two dimensional (2D) or a three dimensional (3D) graphicalmodel of a directional lead associated with one or more VEs on the leadrepresentation. The one or more VEs may include a 2D or 3D graphicalrepresentation of an individual or a combination of two or moreelectrodes, such as column electrodes (also known as ring electrodes,e.g., the electrodes 245 in FIG. 2B), or segmented electrodescircumferentially disposed on a directional lead (e.g., the electrodes240 in FIG. 2A).

The SGR of the lead and the VEs may include graphical representation ofa lead from a particular viewing perspective, such as one of a pluralityof orthographic views, or a projection onto a specified plane. In anexample, the SGR of the lead and the VE may include at least a firstview and a second view of the lead. The first view may provide alongitudinal representation of the VE, which represents a longitudinalposition of the VE along a length of the lead. In an example, the firstview of the directional lead is an isometric view illustrating alongitudinal length of a portion of the directional lead. The secondview may provide a circumferential representation of the VE representinga circumferential position of the VE around at least a portion of acircumference of the lead. In an example, the second view is a sectionalview, such as a cross-sectional view, of the lead. Examples of thedisplay of a SGR of a lead and the associated VEs are discussed below,such as with reference to FIGS. 4-7.

The display screen may be configured to additionally display a pluralityof control elements 383. The control elements 383 may be shown as iconsor bitmaps, optionally associated with text labels or markers indicatingthe function or manner of operation of the corresponding controlelements. The control elements may include checkboxes, push buttons,radio buttons, or other user interface controls located on the displayscreen.

The control elements 383 enables a system user to adjust the SGR of thelead and VEs, such as: to activate or deactivate a SGR of a lead or aVE; to switch among various different views such as between the firstview and the second view; to zoom, pan, rotate, or otherwise edit atleast a portion of the SGR of the lead or a VE; or to adjust theposition, shape, size, or focus or spread of one or more VEs. In anexample, the user interface may include one or more input devices thatenable the system user to adjust the SGR of the lead or the VEs on thedisplay screen, such as by activating or navigating through the controlelements 383. The input device may include a keyboard, on-screenkeyboard, mouse, trackball, touchpad, touch-screen, or other pointing ornavigating devices. Examples of the control elements for controlling aSGR of the lead and the associated VEs are discussed below, such as withreference to FIGS. 4-7.

The programmer module 384 may be coupled to the user interface 381 andconfigured to use the SGR of the lead and the VEs to generate aneuromodulation parameter set, and program the neuromodulation system310 with the neuromodulation parameter set. The neuromodulationparameter set may include spatial information about neuromodulation,including electrode configuration, electrode combinations that defineneuromodulation vectors, polarity of electrodes including electrodesthat are activated as anodes (positive) or cathodes (negative) or beingturned off, fractionalized electrode configurations indicatingfractionalized distribution (e.g., percentage of stimulation energy)assigned to each electrode, among others. In an example, the programmermodule 384 may generate the neuromodulation parameter set using acomputational model or an anatomical model stored in the memory circuit386. The computational or anatomical model may use the longitudinalrepresentation of the VE and the circumferential representation of theVE, along with other parameters such as electrode-tissue properties, toestimate neuromodulation field established by electrodes represented bythe VE and tissue responses to the neuromodulation, among others. Theprogrammer module 384 may use the estimated neuromodulation field andother information to generate the neuromodulation parameter set. Theprogrammer module 384 may be coupled to the memory circuit 386, whichreceives and stores the neuromodulation parameter set.

The I/O circuit 387 may include a telemetry circuit to output theneuromodulation parameter set to the neuromodulation system 310. The I/Ocircuit may also receive from the neuromodulation system 310 parametersindicating operational status of the pulse generator within theneuromodulation system 310, such as battery longevity indicators of theIND 110, lead impedance or lead integrity indicators of the lead 130, orphysiological signals sensed by using one or more electrodes 140. TheI/O circuit may also receive neuromodulation parameter set that hasalready been stored in the memory 386.

The controller circuit 385 may control the display of the SGR of theleads and the VE and the control elements, and adjustment of thedisplayed objects on the display screen in response to a user's inputsuch as activating a control element via a user input device. Thecontroller circuit 385 may control the programmer module 384 ingenerating the neuromodulation parameter set, and storing theneuromodulation parameter set in the memory circuit 386. In an example,the neuromodulation programming system 380 may program theneuromodulation system with at least the neuromodulation parameter set,such as via the communication link 370.

FIG. 4 illustrates, by way of example and not limitation, an example ofSGR of one or more leads and the associated VEs 410 and thecorresponding control elements 450 for use by a system user to adjustthe SGR of the leads and the VEs on a display screen. The SGR of thelead and VEs 410 and the control elements 450 may be displayed on adisplay screen. A system user may interactively adjust the display ofthe SGR of the lead and VEs 410 by using one or more of the controlelements 450. By way of non-limiting examples, one or more SGRs withassociated VEs, and the control elements for adjusting the SGRs or theVEs, may be displayed on the display screen in a plan view asillustrated in FIG. 8. The display may include a user control panel 801to display various control elements, and a lead display zone 802 todisplay the SGRs of the lead and VEs. A system user may adjust thedisplay of the SGR of the lead and VEs using the control elements on theuser control panel 801, or alternatively or additionally using on-screencontrol to edit the SGR of the lead and VEs within the lead display zone802.

The SGR of the lead and the VEs may include a first view 420 oflongitudinal representation of the VE, and a second view 430 ofcircumferential representation of the VE. The first view 420 may providea longitudinal position 422 of the VE along a length of the directionallead. By way of non-limiting example, and as illustrated in FIGS. 5A-B,SGRs of a lead 510 with a first VE 520A and a second VE 520B may bedisplayed on the display screen. The lead representation 510 is shown asa simplified 2D representation of a lead, and the two VEs 520A and 520Bare shown as simplified 2D representation of actual neuromodulationelectrodes. FIGS. 5A-B each shows different longitudinal positions ofthe VEs 520A and 520B, as indicated by a distance from a tip 511 of theSGR of the lead 510. The VEs 520A and 520B shown in FIG. 5A are disposedat more distal longitudinal positions (closer to the lead tip 511) thanthe respective VEs shown in FIG. 5B. Adjustment of the longitudinalpositions of the VE, such as from the more distal positions shown inFIG. 5A to more proximal positions shown in FIG. 5B, may be achieved byactivating one of the control elements, as will be discussed below withreference to FIG. 8.

In some examples, the first view 420 may additionally provide alongitudinal shape, size, or spread (SSS) 424 of the VE along the lengthof the directional lead. By way of non-limiting example, and asillustrated in FIGS. 5A-B, the VEs 520A and 520B have longitudinal shapeof rectangles with respective heights 521A and 521B. The longitudinalSSS of a VE, such as the height 521A and 521B, may be indicative orcorrelative of the distribution of the electrical field established bythe modulation current flowing from the electrodes to the neighboringtissue. Adjustment of the longitudinal SSS of the VE may be achieved byactivating one of the control elements, as will be discussed below withreference to FIG. 8.

The second view 430 may provide a circumferential position 432 of theVE, representing a position of the VE around at least a portion of acircumference of the directional lead. By way of non-limiting example,and as illustrated in FIGS. 6A-B, a SGR of a lead 610 with a VE 620 canbe displayed on the display screen. The VE 620 represents a segmentedelectrode circumferentially distributed around a portion of acircumference of the lead body 615. FIG. 6A illustrates a first view ofthe lead 610, which provides a longitudinal position of the VE 620, suchas indicated by a distance from a tip 611 of the SGR of the lead 610.FIG. 6B illustrates a second view of the lead 610, which is across-sectional view 630. The VE in the cross-sectional view has a shapeof an arc defined by two edges 621 or 622 around a circumference 640 ofthe lead 610. The second view provides a circumferential position of theVE 620, representing a position of the VE 620 around at least a portionof the circumference 640. The circumferential position may berepresented by an angle of rotation 650 from a reference direction 612(such as indicating a frontal direction of the lead 610) to a point onthe VE 620 (such as an edge 621 or 622 on the VE 620). Adjustment ofviewing perspectives of the SGR of the lead, such as activating ordeactivating one view or change from a first view to a second view, arediscussed below with reference to FIG. 8.

In some examples, the second view 430 may additionally provide acircumferential shape, size, or spread (SSS) of the VE around at least aportion of a circumference of the directional lead. The circumferentialrepresentation of a VE may have a shape of a ring or an arc around thedirectional lead. The ring-shaped VE may represent a column electrodesuch as the electrodes 245 as shown in FIG. 2B, or a combination of anarray of segmented electrodes covering a full circumference around alead. The arc-shaped VE (e.g., the VE 620 in FIG. 6B) may represent anindividual segmented electrode, or a combination of several segmentedelectrodes covering a portion of a circumference around a lead, such asthe electrodes 240 as shown in FIG. 2A.

The circumferential SSS of a VE may be indicative or correlative of thedistribution of the electrical field established by the modulationcurrent flowing from the electrodes to the neighboring tissue. In anexample, the circumferential spread of an arc-shaped VE (e.g., the VE620 in FIG. 6B) can be measured as an angle of arc, such as angle 660 inFIG. 6B. AVE with a larger spread (e.g., a larger angle of arc of anarc-shaped VE 620) may correspond to less focused electrical fieldestablished by the modulation current. By way of non-limiting examples,and as illustrated in FIGS. 7A-C, cross-sectional views of VEs withdifferent circumferential SSS can be displayed on the display screen. VE710 in FIG. 7A has a circumferential shape of a ring, with a spreadrepresented by an angle of arc 715 equal to 360 degrees. The VE 710 mayrepresent a column electrode such as the electrodes 245 as shown in FIG.2B, or an array of segmented electrodes around a full circumference ofthe lead. VE 720 in FIG. 7B has a circumferential shape of an arc with aspread represented by an angle of arc 725 less than 360 degrees andgreater than 180 degrees. VE 730 in FIG. 7C has a circumferential shapeof an arc with a spread represented by an angle of arc 735 less than 180degrees. Therefore, the VE 710 has a full circumferential spread, or nofocus, of the electrical field established in tissue neighboring theelectrodes. The VE 720 represents an electrode or electrode combinationwith less circumferential spread, or more focus, than the VE 710. The VE730 has the smallest angle of arc 735 among the three VEs shown in FIGS.7A-C, and may represent an electrode or electrode combination with leastcircumferential spread, or highest level of focus. Adjustment of thecircumferential SSS of the VE may be achieved by activating one of thecontrol elements, as will be discussed below with reference to FIG. 8.

The SGRs of the leads and the associated VEs 410 may be adjusted by auser via a plurality of control elements 450 that may be displayed onthe display screen. The control elements 450 may include view controlelements 460, VE activation control elements 470, and VE controlelements 480.

The view control elements 460 enables a system user to activate ordeactivate a display of the SGR of the lead and the associated VEs shownin a particular viewing perspective, or to switch from one perspectiveto another different perspective. By way of non-limiting examples, theview control element 460 may include a view perspective box on thedisplay screen, such as the view perspective box 810 on the controlpanel 801 in FIG. 8 that displays multiple viewing perspectives. Theview perspective box 810 may include control buttons (e.g., checkboxes,radio buttons, or switch buttons) associated with respective text labelsof “longitudinal” or “circumferential.” The user may check the“longitudinal” checkbox to display the first view of a longitudinalrepresentation of the VE (e.g., the VE 620 in FIG. 6A), or check the“circumferential” checkbox to display the second view of acircumferential representation of the VE (e.g., the VE 620 in FIG. 6B).

In an example, the view perspective box 810 may include a “camera mode”view perspective that enables the user to activate and edit the SGR ofthe lead to obtain continuously changing perspectives of the SGR of thelead. For example, the user may use a pointing device (e.g., a keyboard,an on-screen keyboard, a mouse, a trackball, a touchpad, atouch-screen), or other on-screen selection and control method, toactivate and rotate the SGR of the lead. This effectually resemblesimaging the SGR of the lead with a camera moving around within the spacearound a 3D SGR of the lead. Different views of the SGR of the lead,including the longitudinal and circumferential views, may besimultaneously displayed in accordance with the user's control. Adesired view may be displayed as a still image through the user'scontrol, such as via drag-and-drop operation of the SGR of the lead inthe camera mode. In some examples, a selected view of the SGR of thelead, or any view obtained when the “camera” is set to a certain viewunder the “camera mode”, may be augmented or adjusted. For example, in acircumferential view, certain portions of the SGR of the lead may berendered transparent, or various UI changes may occur.

The VE activation control elements 470 enables a user to selectivelyactivate, deactivate, show, or hide at least one of two or more VEsassociated with the SGR of the lead. For an activated VE, the user maycontrol one or more of position, size, shape, spread, or otherproperties of the activated VE. By way of non-limiting examples, the VEactivation control element can include a VE activation box 820 on thecontrol panel 801 in FIG. 8. The VE activation box 820 may includecheckboxes associated with respective text labels of “VE-1” or “VE-2”.The user may select a VE by checking the corresponding checkbox.Alternatively, the user may use a pointing device, or other on-screenselection and control method, to activate a VE, such as by pointing toor clicking on a VE using a pointing device.

The VE control elements 480 may include longitudinal control elements482 and circumferential control elements 484. The longitudinal controlelements 482 enable the user to adjust the longitudinal representationof the VE including the longitudinal position of the VE along the lengthof the directional lead such as in the first view (i.e., longitudinalview of the SGR of the lead).

The longitudinal control elements 482 may include at least onelongitudinal position icon with a longitudinal direction indicator,which enables a user to incrementally adjust the longitudinal positionof the VE along the lead representation (i.e., the longitudinal position422 of the VE) in a direction according to the at least one longitudinaldirection indicator. By way of non-limiting examples, the longitudinalcontrol elements can include a “longitudinal position” box 832 displayedon the control panel 801 in FIG. 8. The longitudinal position” box 832may include a first longitudinal direction icon 832A indicating adownward movement of the VE along the length of the lead, and a secondlongitudinal direction icon 832B indicating an upward movement of the VEalong the length of the lead. To change the longitudinal positions ofone or more VEs, such as moving the VEs 520A and 520B from their moredistal positions (e.g., closer to the lead tip 511) shown in FIG. 5A tomore proximal positions (e.g., farther away from the lead tip 511) inFIG. 5B, the user may activate one or both of the VEs 520A and 520B bychecking the corresponding VE activation checkboxes, and then activate(e.g., clicking on or pressing) 832B until the selected VEs are shown onthe display screen to move upward incrementally until they reach thedesired longitudinal positions. The user may similarly move thelongitudinal positions of the selected VEs downward toward the lead tip511.

In some examples, the longitudinal control elements 482 enables a userto adjust the longitudinal position using a selection and control methodto select a first portion of the longitudinal representation of the VE,and edit the longitudinal representation including the longitudinalposition of the VE along the directional lead. For example, withreference to FIGS. 5A-5B, a user may be enabled to use a pointing deviceto point to, or touch at, a middle portion of the length of the VE tograb and drag the VE in a desired direction, such as moving the VEdistally along the lead toward the tip 511, or proximally along the leadaway from the tip 511.

The longitudinal control elements 482 may additionally or alternativelyenable the user to adjust the longitudinal size, shape, or spread (SSS)of the VE. The longitudinal control elements 482 may include at leastone longitudinal spread icon with a longitudinal spread indicator. Thelongitudinal spread icon enables a user to incrementally adjust alongitudinal dimension of the longitudinal representation of the VE suchas in the first view (i.e., the longitudinal view of the SGR of thelead). By way of non-limiting examples, the longitudinal controlelements can include a “longitudinal spread” box 834 on the controlpanel 801 in FIG. 8. The “longitudinal spread” box 834 may include afirst longitudinal spread icon 834A indicating a lengthening of the VEalong the length of the lead, and a second longitudinal spread icon 832Bindicating a shortening of the VE along the length of the lead. Toadjust the longitudinal SSS of a VE, such as to change the shape orheight of one or both of the VEs 520A and 520B in FIGS. 5A-B, the usermay activate the VEs such as by checking the corresponding VE activationcheckboxes, and then activate (e.g., clicking on or pressing) 834A untilthe selected VEs are shown on the display screen to lengthenincrementally until they reach the desired longitudinal dimension.Similarly, the user may activate 834B to shorten the longitudinaldimension of the selected VEs.

In some examples, the longitudinal control elements 482 enables a userto adjust the longitudinal spread using a selection and control methodto select a second portion of the longitudinal representation of the VE,and edit the longitudinal representation of the VE along the directionallead. For example, with reference to FIG. 5A, a user may be enabled touse a pointing device to point to, or touch at, an edge portion 531A or541A of the longitudinal representation of the VE, and to grab and dragthe VE 520A along the directional lead to adjust a longitudinaldimension of the longitudinal representation of the VE such as in thefirst view. For example, grabbing and dragging the edge 541A upwards mayresult in a lengthened VE 520A, while grabbing and dragging the edge541A downwards towards the edge 531A may result in a shortened VE 520A.

The circumferential control elements 484 may enable the user to adjustthe circumferential representation of the VE such as in the second view(e.g., a circumferential view of the SGR of the lead). Thecircumferential control elements 484 may include at least onecircumferential position icon with a circumferential directionindicator. The circumferential position icon enables a user toincrementally adjust the circumferential position of the VE around thecircumference of the directional lead in a direction according to thecircumferential direction indicator. By way of non-limiting examples,the circumferential control elements can include a “circumferentialposition” box 842 displayed on the control panel 801 in FIG. 8. The“circumferential position” box 842 may include a first circumferentialdirection icon 842A indicating a counter-clockwise rotation of the VEaround a circumference of the lead in a cross-sectional view of the VE,and a second circumferential direction icon 842B indicating a clockwiserotation of the VE around the circumference of the lead in thecross-sectional view of the VE. To adjust the circumferential positionof a VE, such as reposition the VE 620 in a clockwise direction 660 asshown in FIG. 6B, the user may active (e.g., click on or press) 842Buntil the VE 620 are shown on the display screen to rotate clockwiseincrementally around the circumference 640 until it reaches the desiredcircumferential position. Similarly, the user may activate 842A torotate the VE 620 counter-clockwise around the circumference 640.

In some examples, the circumferential control elements 484 enable a userto adjust the circumferential position using a selection and controlmethod to select a first portion of the circumferential representationof the VE, and edit the circumferential position of the VE around acircumference of the directional lead. For example, with reference toFIGS. 6A-B, a user may be enabled to use a pointing device to point to,or touch at, a middle portion of an arc-shaped VE 620 to grab and rotatethe VE 620 in a desired rotational direction, such as clockwise orcounter-clockwise.

The circumferential control elements 484 may additionally oralternatively enable the user to adjust the circumferential size, shape,or spread (SSS) of the VE. The circumferential control elements 484 mayinclude at least one circumferential spread icon with a circumferentialspread indicator. The circumferential spread icon enables a user toincrementally adjust a circumferential dimension of the circumferentialrepresentation of the VE such as in the second view (i.e., thecircumferential view of the SGR of the lead). By way of non-limitingexamples, the circumferential control elements can include a“circumferential spread” box 844 on the control panel 801 in FIG. 8. The“circumferential spread” box 844 may include a first circumferentialspread icon 844A indicating a decrease in the circumferential spreadaround a circumference of the lead, and a second circumferential spreadicon 844B indicating an increase in the circumferential spread aroundthe circumference of the lead. To adjust the circumferential SSS of aVE, such as to reduce the spread of the VE 710 in FIG. 7, the user mayactivate (e.g., click on or press) 844A to incrementally decrease theangle of arc until a desired circumferential dimension is reached (e.g.,the angle of arc is decreased from a first angle 715 to a second angle725, or further down to a third angle 735). Similarly, the user mayactivate 844B to increase the circumferential spread of the VE.

In some examples, the circumferential control elements 484 enable a userto adjust the circumferential spread using a selection and controlmethod to select a second portion of the circumferential representationof the VE, and edit the circumferential representation of the VE arounda circumference of the directional lead. For example, with reference toFIG. 7B, a user may be enabled to use a pointing device to point to, ortouch at, an edge portion 726A of the circumferential representation ofthe VE, and to grab and rotate the edge 726A clockwise around thecircumference of the directional lead towards 726B to reduce the angle725 and thereby reducing the circumferential spread of the VE 720.

FIG. 9 illustrates, by way of example and not limitation, an example ofa method 900 for creating and using a SGR of a lead to determine aneuromodulation parameter set for programming a neuromodulation systemand delivering neuromodulation to a neural target such as a brain, aspinal cord, or a peripheral neural tissue. The lead may be adirectional lead that carries one or more segmented electrodes at leastpartially surrounding a circumference of the lead, such as the leads230A and 230B shown in FIG. 2A. The lead may carry one or more columnelectrodes (also known as ring electrodes) axially disposed along thelength of the lead body, such as the leads 235A and 235B shown in FIG.2B. The method 900 may be implemented and operate in a medical system,such as the programming system 180 as shown in FIG. 1, or theneuromodulation system 300 as shown in FIG. 3, or any modificationthereof. The method 900 may be used intraoperatively (e.g., duringimplant of a neuromodulation system in an operating room) or during apatient follow-up visit.

The method 900 begins at 910, where a user interface is provided. Theuser interface, such as the user interface 381 as shown in FIG. 3, mayinclude a display screen configured to display simplified graphicalrepresentation (SGR) 382 of one or more leads along with representationof one or more virtual electrodes (VEs) associated with the leadrepresentation.

At 920, the SGR of the one or more leads, along with the associated VEs,may be displayed on the display screen. The SGR of the lead is a“simplified” representation, rather than a proportional depiction of thecorresponding lead with actual physical size, shape, extent, ordimension. The VE associated with the SGR of the lead is a “simplified”representation of one electrode or an array of electrodes, rather than aproportional depiction of the electrode(s) with actual geometric orphysical properties such as size, shape, dimension, position ororientation such as with respect to a radial axis of the lead, orinter-electrode spacing, among others.

The SGR of the lead and the VEs may include graphical representation ofa lead from a particular viewing perspective, such as one of a pluralityof orthographic views, or a projection onto a specified plane. In anexample, and as shown in the lead display zone 802 of FIG. 8, the SGR ofthe lead and the VE may include at least a first view and a second viewof the lead. In an example, the first view of the directional lead is anisometric view illustrating a longitudinal length of a portion of thedirectional lead. The first view provides a longitudinal representationof the VE, which represents a longitudinal position of the VE along alength of the lead. The first view may additionally provide alongitudinal shape, size, or spread (SSS) 424 of the VE along the lengthof the directional lead, such as the VEs 520A and 520B each having arespective longitudinal shape of a rectangle with respective heights521A and 521B. The longitudinal SSS of a VE may be indicative orcorrelative of the distribution of the electrical field established bythe modulation current flowing from the electrodes to the neighboringtissue.

The second view provides a circumferential representation of the VEaround at least a portion of a circumference of the lead. In an example,the second view is a sectional view of the lead, such as across-sectional view 630 of the lead 610, as shown in FIG. 6B. Thesecond view may additionally provide a circumferential SSS of the VEaround at least a portion of a circumference of the directional lead.The circumferential SSS of a VE, such as the spread as represented by anangle 660 of arc corresponding to the arc-shaped VE, may be indicativeor correlative of the distribution of the electrical field establishedby the modulation current flowing from the electrodes to the neighboringtissue.

Also at 920 a plurality of control elements may be displayed on thedisplay screen. The control elements, such as those displayed in theuser control panel 801 shown in FIG. 8, may be shown as icons orbitmaps, optionally associated with text labels or markers indicatingthe function or manner of operation of the corresponding controlelements. The control elements may be displayed as checkboxes, pushbuttons, radio buttons, or other UI controls located on the displayscreen. The control elements enable a system user to adjust the SGR ofthe lead and VEs.

At 930, a user is enabled to use the control elements to adjust the SGRof the lead and the VE as displayed on the display screen, and determinefor each VE one or more of a desired longitudinal position, a desiredlongitudinal size, shape, or spread, a desired circumferential position,a desired circumferential size, shape, or spread. The control elementsmay include view control elements, VE activation control elements, andVE control elements which may further include longitudinal controlelements and circumferential control elements. As previously discussedwith respect to FIG. 8, the view control elements enable a system userto activate or deactivate a display of the SGR of the lead and theassociated VEs shown in a particular viewing perspective, or to switchfrom one perspective to another different perspective. The VE activationcontrol elements enable a user to selectively activate, deactivate,show, or hide one of two or more VEs associated with the SGR of thelead. Both the view control elements and the VE activation controlelements may be used in the first, second, or any other user-specifiedview SGR of the lead.

The longitudinal control elements enable the user to adjust thelongitudinal representation of the VE along the length of thedirectional lead such as in the first view (i.e., longitudinal view ofthe SGR of the lead), such as by adjusting the longitudinal positions ofone or both of the VEs 520A and 520B in FIG. 5A to more proximalpositions shown in FIG. 5B. The longitudinal control elements mayadditionally or alternatively enable the user to adjust the longitudinalsize, shape, or spread (SSS) of the VE, such as lengthening orshortening the longitudinal dimension (or, height) of the VE 520A or520B in FIGS. 5A-B. Adjustment of the longitudinal position or thelongitudinal SSS may be achieved by activating corresponding controlelements, such as the longitudinal position icons 832A-B or thelongitudinal spread icons 834A-B as shown in FIG. 8, or by on-screenselection and control of the longitudinal representation of the VE, suchas by using a pointing device to activate and edit the longitudinalrepresentation of the VE on the display screen.

The circumferential control elements 484 enable the user to adjust thecircumferential representation of the VE such as in the second view(e.g., a circumferential view of the SGR of the lead), such as byadjusting the circumferential positions of one or both of the VE 620around a circumference of the lead in a cross-sectional view of the VE,as illustrated in FIG. 6B. The circumferential control elements mayadditionally or alternatively enable the user to adjust thecircumferential SSS of the VE, such as reducing the circumferentialspread of the VE 710 by decreasing the angle of arc 715 to a secondangle 725, and further down to a third angle 735, until a desiredcircumferential dimension is reached. Adjustment of the circumferentialposition or the circumferential SSS may be achieved by activatingcorresponding control elements, such as the circumferential positionicons 842A-B or the circumferential spread icons 844A-B as shown in FIG.8, or by on-screen selection and control of the circumferentialrepresentation of the VE, such as by using a pointing device to activateand edit the circumferential representation of the VE on the displayscreen.

At 940, the SGR of the lead and the VEs may be used to generate aneuromodulation parameter set, such as by using the programmer module384. The neuromodulation parameter set may include spatial informationneuromodulation, including electrode configuration, electrodecombinations that define neuromodulation vectors, polarity of electrodesincluding electrodes that are activated as anodes (positive) or cathodes(negative) or being turned off, fractionalized electrode configurationsindicating fractionalized distribution (e.g., percentage of stimulationenergy) assigned to each electrode, among others.

At 950, the neuromodulation parameter set may be programmed into theneuromodulation system, such as the neuromodulation system 310 in FIG. 3or the IPG 110 in FIG. 1, via a communication link such as an inductivetelemetry link or a radio-frequency telemetry link. At 960,neuromodulation energy (such as in a form of electrostimulation pulses)may be generated by the neuromodulation system and delivered to a neuraltarget using the lead, in accordance with the neuromodulation parameterset.

In some examples, the method 900, or variants of any part of the method900, may be implemented as instructions stored in a machine-readablestorage medium. The machine may be in a form of a computer system, whichmay include a processor, memory, video display unit, an alpha-numericinput device, a user interface with a navigation device, a disk driveunit, a signal generation device, a network interface device, amongothers. The instructions may cause machine to perform any part of themethod 900 or any variants thereof. The machine may operate as astandalone device or may be connected (e.g., networked) to othermachines. While only a single machine is illustrated, the term “machine”shall also be taken to include any collection of machines thatindividually or jointly execute a set (or multiple sets) of instructionsto perform any one or more of the methodologies discussed herein.

The machine-readable medium may include a single medium or multiplemedia (e.g., a centralized or distributed database, and/or associatedcaches and servers) that store the one or more instructions or datastructures. The term “machine-readable storage medium” shall also betaken to include any tangible medium that is capable of storing,encoding or carrying instructions for execution by the machine and thatcause the machine to perform any one or more of the methods of thepresent invention, or that is capable of storing, encoding or carryingdata structures used by or associated with such instructions. The term“machine-readable storage medium” shall accordingly be taken to include,but not be limited to, solid-state memories, and optical and magneticmedia. Specific examples of machine-readable media include non-volatilememory, including by way of example, semiconductor memory devices (e.g.,erasable programmable read-only memory (EPROM), electrically erasableprogrammable read-only memory (EEPROM)) and flash memory devices;magnetic disks such as internal hard disks and removable disks;magneto-optical disks; and CD-ROM and DVD-ROM disks. A “machine-readablestorage medium” shall also include devices that may be interpreted astransitory, such as register memory, processor cache, and RAM, amongothers. The definitions provided herein of machine-readable medium andmachine-readable storage medium are applicable even if themachine-readable medium is further characterized as being“non-transitory.” For example, any addition of “non-transitory,” such asnon-transitory machine-readable storage medium, is intended to continueto encompass register memory, processor cache and RAM, among othermemory devices.

In various examples, the instructions may further be transmitted orreceived over a communications network using a transmission medium. Theinstructions may be transmitted using the network interface device andany one of a number of well-known transfer protocols (e.g., HTTP).Examples of communication networks include a LAN, a WAN, the Internet,mobile telephone networks, plain old telephone (POTS) networks, andwireless data networks (e.g., WiFi and WiMax networks). The term“transmission medium” shall be taken to include any intangible mediumthat is capable of storing, encoding or carrying instructions forexecution by the machine, and includes digital or analog communicationssignals or other intangible media to facilitate communication of suchsoftware.

The above detailed description includes references to the accompanyingdrawings, which form a part of the detailed description. The drawingsshow, by way of illustration, specific embodiments in which theinvention may be practiced. These embodiments are also referred toherein as “examples.” Such examples may include elements in addition tothose shown or described. However, the present inventors alsocontemplate examples in which only those elements shown or described areprovided. Moreover, the present inventors also contemplate examplesusing combinations or permutations of those elements shown or described.

Method examples described herein may be machine or computer-implementedat least in part. Some examples may include a computer-readable mediumor machine-readable medium encoded with instructions operable toconfigure an electronic device to perform methods as described in theabove examples. An implementation of such methods may include code, suchas microcode, assembly language code, a higher-level language code, orthe like. Such code may include computer readable instructions forperforming various methods. The code may form portions of computerprogram products. Further, in an example, the code may be tangiblystored on one or more volatile, non-transitory, or non-volatile tangiblecomputer-readable media, such as during execution or at other times.Examples of these tangible computer-readable media may include, but arenot limited to, hard disks, removable magnetic disks, removable opticaldisks (e.g., compact disks and digital video disks), magnetic cassettes,memory cards or sticks, random access memories (RAMs), read onlymemories (ROMs), and the like.

The above description is intended to be illustrative, and notrestrictive. For example, the above-described examples (or one or moreaspects thereof) may be used in combination with each other. Otherembodiments may be used, such as by one of ordinary skill in the artupon reviewing the above description. The scope of the invention shouldbe determined with reference to the appended claims, along with the fullscope of equivalents to which such claims are entitled.

What is claimed is:
 1. A system for use with a neuromodulation systemthat includes a physical lead having one or more electrodes at leastpartially surrounding a circumference of the physical lead forelectrically modulating a target tissue of a patient, the systemcomprising: a user interface including a display screen configured todisplay: simplified graphical representations of the physical lead withat least one user-modifiable virtual electrode (VE) on the graphicalrepresentation of the physical lead, wherein the user-modifiable VErepresents, as a single VE conforming to the lead representation, acombination of at least two physical electrodes on the physical lead,the simplified graphical representations including one or more of: atleast a first view of the lead representation to provide a longitudinalrepresentation of the VE representing a longitudinal position of the VEalong a length of the lead representation; or at least a second view ofthe lead representation to provide a circumferential representation ofthe VE representing a circumferential position of the VE around at leasta portion of a circumference of the lead representation; controlelements to enable a user to adjust the simplified graphicalrepresentations of the lead, the control elements including:longitudinal control elements to enable the user to adjust thelongitudinal representation of the VE including the longitudinalposition of the VE along the length of the lead representation; andcircumferential control elements to enable the user to adjust thecircumferential representation of the VE including the circumferentialposition of the VE; and a programmer coupled to the user interface,configured to use the longitudinal representation of the VE and thecircumferential representation of the VE to generate a neuromodulationparameter set.
 2. The system of claim 1, wherein: the first view of thelead representation is a view illustrating a longitudinal length of aportion of the lead representation, and the second view is a sectionalview of the lead representation; and the control elements include one ormore view control elements to enable a user to select between at leastthe first and second views of the lead representation.
 3. The system ofclaim 1, wherein the simplified graphical representations of the leadinclude two or more VEs, and wherein the control elements include atleast one VE activation control element to selectively activate,deactivate, show, or hide at least one of the two or more VEs.
 4. Thesystem of claim 1, wherein: the first view of the lead representationfurther provides a representation of longitudinal size, shape, or spreadof the VE along the length of the lead representation; and thelongitudinal control elements further enable the user to adjust thelongitudinal size, shape, or spread of the VE.
 5. The system of claim 4,wherein the longitudinal control elements include: at least onelongitudinal position icon with a longitudinal direction indicator, thelongitudinal position icon enabling a user to incrementally adjust thelongitudinal representation of the VE along the lead representation in adirection according to the at least one longitudinal directionindicator; and at least one longitudinal spread icon with a longitudinalspread indicator, the longitudinal spread icon enabling a user toincrementally adjust a longitudinal size, shape, or spread of thelongitudinal representation of the VE in the first view.
 6. The systemof claim 4, wherein the longitudinal control elements enable a user to:adjust the longitudinal position using a selection and control method toselect a first portion of the longitudinal representation of the VE andedit the longitudinal representation of the VE along the leadrepresentation; and adjust the longitudinal size, shape, or spread usingthe selection and control method to select a second portion of thelongitudinal representation of the VE and edit an edge of thelongitudinal representation of the VE along the lead representation toadjust a longitudinal dimension of the longitudinal representation ofthe VE in the first view.
 7. The system of claim 1, wherein thelongitudinal control elements are further configured to enable a user toadjust, in the first view, one or more of: a polarity of thelongitudinal representation of the VE; a modulation vectorconfiguration; or a distance between the longitudinal representation ofthe VE and a longitudinal representation of a reference electrode. 8.The system of claim 1, wherein: the second view of the leadrepresentation further provides a representation of circumferentialsize, shape, or spread of the VE around the length of the leadrepresentation; and the circumferential control elements further enablethe user to adjust the circumferential size, shape, or spread of the VE.9. The system of claim 8, wherein the circumferential control elementsinclude: at least one circumferential position icon with acircumferential direction indicator, the circumferential position iconenabling a user to incrementally rotate the circumferentialrepresentation of the VE around the circumference of the leadrepresentation in a direction according to the circumferential directionindicator; and at least one circumferential spread icon with acircumferential spread indicator, the circumferential spread iconenabling a user to incrementally adjust a circumferential size, shape,or spread of the circumferential representation of the VE in the secondview.
 10. The system of claim 8, wherein the circumferential controlelements enable a user to: adjust the circumferential position using aselection and control method to select a first portion of thecircumferential representation of the VE and edit the circumferentialrepresentation of the VE around the circumference of the leadrepresentation; and adjust the circumferential size, shape, or spreadusing the selection and control method to select a second portion of thecircumferential representation of the VE and edit an edge of thecircumferential representation of the VE around the circumference of thelead representation to adjust the circumferential dimension of thecircumferential representation of the VE in the second view.
 11. Thesystem of claim 8, wherein the circumferential representation of the VEincludes a ring or an arc around the lead representation, and whereinthe circumferential spread of the VE includes an angle of the ring orthe arc.
 12. The system of claim 1, further comprising: aneuromodulation system including an electrostimulation generatorconfigured to be operably connected to the physical lead to deliverneuromodulation using the physical lead; and a programming systemincluding the programmer and the user interface, the programming systemcommunicatively coupled to the neuromodulation system, and configured toprogram the neuromodulation system with the neuromodulation parameterset.
 13. A system, comprising: a neuromodulation system including anelectrostimulation generator configured to be operably connected to aphysical lead that includes a plurality of electrodes along alongitudinal direction of the physical lead, at least some of theplurality of electrodes including electrodes at least partiallysurrounding a circumference of the physical lead; a programming systemcommunicatively coupled to the neuromodulation system, the programmingsystem including a display screen and configured to display on thedisplay screen (1) simplified graphical representations of the physicallead with at least one user-modifiable virtual electrode (VE) on thegraphical representation of the physical lead, wherein theuser-modifiable VE represents, as a single VE conforming to the leadrepresentation, a combination of at least two physical electrodes on thephysical lead, and (2) control elements to enable a user to adjust thesimplified graphical representations of the lead, wherein the simplifiedgraphical representations include one or more of: at least a first viewof the lead representation to provide a longitudinal representation ofthe VE representing a longitudinal position of the VE along a length ofthe lead representation, and a longitudinal size, shape, or spread ofthe VE along the length of the lead representation; or at least a secondview of the lead representation to provide a circumferentialrepresentation of the VE representing a circumferential position of theVE around at least a portion of a circumference of the leadrepresentation, and a circumferential size, shape, or spread of the VEaround the circumference of the lead representation; wherein the controlelements include: longitudinal control elements to enable the user toadjust the longitudinal representation of the VE including thelongitudinal position and the longitudinal size, shape, or spread of theVE; and circumferential control elements to enable the user to adjustthe circumferential representation of the VE including thecircumferential position and the circumferential size, shape, or spreadof the VE; and wherein the programming system is configured to use thelongitudinal representation of the VE and the circumferentialrepresentation of the VE to determine a neuromodulation parameter set,and program the neuromodulation system using the neuromodulationparameter set.
 14. A method for generating a neuromodulation parameterset to program a neuromodulation system that includes a physical leadhaving one or more electrodes at least partially surrounding acircumference of the physical lead for electrically modulating a targettissue of a patient, the method comprising: providing a user interfacethat includes a display screen; displaying on the display screen:simplified graphical representations of the physical lead with at leastone user-modifiable virtual electrode (VE) on the graphicalrepresentation of the physical lead, wherein the user-modifiable VErepresents, as a single VE conforming to the lead representation, acombination of at least two physical electrodes on the physical lead,the simplified graphical representations including one or more of (1) atleast a first view of the lead representation to provide a longitudinalrepresentation of the VE representing a longitudinal position of the VEalong a length of the lead representation, and a longitudinal size,shape, or spread of the VE along the length of the lead representation;or (2) at least a second view of the lead representation to provide acircumferential representation of the VE representing a circumferentialposition of the VE around at least a portion of a circumference of thelead representation, and a circumferential size, shape, or spread of theVE around the circumference of the lead representation; and controlelements to enable a user to adjust the simplified graphicalrepresentations of the lead, the control elements including (1)longitudinal control elements to enable the user to adjust thelongitudinal representation of the VE including the longitudinalposition and the longitudinal size, shape, or spread of the VE, and (2)circumferential control elements to enable the user to adjust thecircumferential representation of the VE including the circumferentialposition and the circumferential size, shape, or spread of the VE;determining, for the at least one VE, one or more of a desiredlongitudinal position, a desired longitudinal size, shape, or spread, adesired circumferential position, a desired circumferential size, shape,or spread; and generating a neuromodulation parameter set using thelongitudinal representation of the VE and the circumferentialrepresentation of the VE for delivering neuromodulation using thephysical lead.
 15. The method of claim 14, wherein: the first view ofthe lead representation is a view illustrating a longitudinal length ofa portion of the lead representation, and the second view is a sectionalview of the lead representation; and the control elements include one ormore view control elements to enable a user to select between at leastthe first and second views of the lead representation.
 16. The method ofclaim 14, wherein the longitudinal control elements include: at leastone longitudinal position icon with a longitudinal direction indicator,the longitudinal position icon enabling a user to incrementally adjustthe longitudinal representation of the VE along the lead representationin a direction according to the at least one longitudinal directionindicator; and at least one longitudinal spread icon with a longitudinalspread indicator, the longitudinal spread icon enabling a user toincrementally adjust a longitudinal size, shape, or spread of thelongitudinal representation of the VE in the first view.
 17. The methodof claim 14, wherein the longitudinal control elements enable a user to:adjust the longitudinal position using a selection and control method toselect a first portion of the longitudinal representation of the VE andedit the longitudinal representation of the VE along the leadrepresentation; and adjust the longitudinal size, shape, or spread usingthe selection and control method to select a second portion of thelongitudinal representation of the VE and edit an edge of thelongitudinal representation of the VE along the lead representation toadjust a longitudinal dimension of the longitudinal representation ofthe VE in the first view.
 18. The method of claim 14, wherein thecircumferential control elements include: at least one circumferentialposition icon with a circumferential direction indicator, thecircumferential position icon enabling a user to incrementally rotatethe circumferential representation of the VE around the circumference ofthe lead representation in a direction according to the circumferentialdirection indicator; and at least one circumferential spread icon with acircumferential spread indicator, the circumferential spread iconenabling a user to incrementally adjust a circumferential size, shape,or spread of the circumferential representation of the VE in the secondview.
 19. The method of claim 14, wherein the circumferential controlelements enable a user to: adjust the circumferential position using aselection and control method to select a first portion of thecircumferential representation of the VE and edit the circumferentialrepresentation of the VE around the circumference of the leadrepresentation; and adjust the circumferential size, shape, or spreadusing the selection and control method to select a second portion of thecircumferential representation of the VE and edit an edge of thecircumferential representation of the VE around the circumference of thelead representation to adjust the circumferential dimension of thecircumferential representation of the VE in the second view.
 20. Themethod of claim 14, further comprising: programming the neuromodulationsystem with the neuromodulation parameter set; and; deliveringneuromodulation using neuromodulation system according to theneuromodulation parameter set.